Biomechanical analysis on of anterior transpedicular screw-fixation after two-level cervical corpectomy using finite element method |
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| Institution: | 1. Ningbo No.6 Hospital, 1059#, Zhongshan Dong Road, Ningbo City, Zhejiang Province, PR China;2. Jinhua people''s Hospital, 228#, Xinhua Road, Jinhua City, Zhejiang Province, PR China;3. University of Toledo Medical Center, 3065 Arlington Avenue, Toledo, OH 43614, USA;4. Ningbo Medical Center Lihuili Eastern Hospital, 1111#, Jiangnan Road, Ningbo City, Zhejiang Province, PR China;1. School of Engineering, University of Guelph, 50 Stone Road East, Guelph, ON N1G 2W1, Canada;2. Division of Anatomy, Department of Surgery, University of Toronto, 1 King''s College Circle, Toronto, ON M5S 1A8, Canada;1. Department of Biomedical Engineering, University of Shanghai for Science and Technology, 516 JunGong Road, Shanghai, China;2. Department of Orthopedic Surgery, YanBian University Hospital, China;3. Department of Biomedical Engineering, College of Biomedical Science & Engineering, Inje University, 607 O-bang, Gyongnam, Republic of Korea;4. Department of Neurosurgery, College of medicine, The Catholic University of Korea, 222 Banpo-Daero, Seoul, Republic of Korea |
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| Abstract: | BackgroundAnterior cervical trans-pedicle screw fixation was introduced to overcome some of the disadvantages associated with anterior cervical corpectomy and fusion. In vitro biomechanical studies on the trans-pedicle screw fixation have shown excellent pull-out strength and favorable stability. Comprehensive biomechanical performance studies on the trans-pedicle screw fixation, however, are lacking.MethodsThe control computed tomography images (C2-T2) were obtained from a 22-year-old male volunteer. A three dimensional computational model of lower cervical spine (C3-T1) was developed using computed tomography scans from a 22 year old human subject. The models of intact C3-T1 (intact group), anterior cervical trans-pedicle screw fixation (trans-pedicle group), and anterior cervical corpectomy and fusion (traditional group) were analyzed with using a finite element software. A moment of 1 N·m and a compressive load of 73.6 N were loaded on the upper surface and upper facet joint surfaces of C3. Under six conditions, four parameters such as the range of motion, titanium mesh plant stress, end-plate stress, and bone-screw stress were measured and compared on two treatment groups.FindingsCompared with the intact model, the range of motions for treatment groups were decreased. Compared with cervical corpectomy and fusion, the titanium plant, C4 upper end-plate and C7 lower end-plate stresses in trans-pedicle group were reduced. No significant difference was discovered on bone-screw stress between the two groups for lateral flexion and rotation, but bone-screw stress is smaller in trans-pedicle group when compared with traditional group. With exception of individual difference, trans-pedicle group had better biomechanical results than traditional group in range of motions, titanium mesh plant stress, end-plate stress and bone-screw stress.InterpretationThe trans-pedicle method has better biomechanical properties than the anterior cervical corpectomy and fusion making it a viable alternative for cervical fixations. |
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